The Mighty Vestibular System
Presented by Tracy Stackhouse
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Meet your instructor
Tracy Stackhouse
Tracy Stackhouse is a clinical pediatric occupational therapist who has specialized in working with children, adults, and families affected by fragile x syndrome (FXS) and Fragile X related conditions since the late 1980s. Through this work, first at Children's Hospital in Denver, continuing at the UC Davis MIND Institute,…
Chapters & learning objectives
1. Why The Vestibular System Is So Mighty
The focus of this training is to deepen understanding of the vestibular system, a system so mighty that it is at the crux of understanding ourselves and the world around us. This chapter introduces what will be covered, identifying the frame of reference (ASI) as well as general terminology. The review will include the functional neuroanatomy and how the sensory information is integrated into key adaptive functions including postural control, motion, equilibrium, spatial orientation, and arousal modulation The course will include general information for assessment and treatment planning. This topic is important for pediatric OTs, as vestibular processing, together with the somatosensory system, form the focal foundation for Ayres' Sensory Integration (ASI) Theory.
2. Receptors: Anatomy Structure and Functions
This chapter provides detailed information about the location, structure, and function of the vestibular apparatus. The vestibular labyrinth includes semicircular canals and macular receptors, the utricle and saccule. The location in the inner ear, the bilateral partnering of the right and left labyrinthine structures, and their relative position in the head are reviewed so that the information received by these structures can be visualized for enhanced clinical reasoning in a vestibular-based intervention approach.
3. Pathways and Functions
Vestibular information is carried via the eighth cranial nerve through central vestibular pathways. The organization of the pathways as they move into the brainstem and then share information across the CNS is presented such that the structure/function relationships are more apparent. This allows the clinician to visualize receptors through pathways to adapt function and increase precision in clinical reasoning for enhanced treatment planning.
4. Adaptive Integrative Functions of the Vestibular System
The vestibular system is mighty, in part because it is structurally and functionally integrated into such a wide range of adaptive functions. This chapter reviews the sensory modulation and sensory discrimination aspects of vestibular contributions to postural/ocular functions, body control, gravity management, balance, and equilibrium, laterality, coordination, spatial, and temporal processing, problem solving, executive functions, social cognition, stability of self, affect/arousal/attention/action regulation systems, and emotional regulation. This range of adaptive capacities ties to Ayres’ theory of vestibular integration being necessary for daily occupational performance and that when difficulties arise, identifying how the vestibular function may be involved allows for proper treatment.
5. Clinical Application of Vestibular System Information
A general idea of basic postural, ocular, balance, spatial, and timing aspects of vestibular integration and how they can be addressed in formal assessments, clinical observations, and within treatment for increasing power and precision and maximizing outcomes is provided in this final chapter.
